This is a competing renewal to extend and expand a longitudinal study (RO1-MH 57207-10). Parents And children Coping Together (PACT) was the original study, designed to longitudinally assess mothers living with HIV (MLHs) and their young, well children 6 to 11 years old. A subsequent study, Parents and Adolescents Coping Together (PACT II), followed up the majority of these families as the children were transitioning to early and middle adolescence (current sample 109 families). The PACT I and II studies have resulted in: 19 publications up to this point (11 published papers, 2 in press, 3 in submission, 3 published chapters); 9 conference presentations (4 international, 5 domestic); and provided data that supported two funded intervention studies for young children with HIV+ mothers, as well as a current STTR submission from a science-to-marketing company. The goal of this competing renewal is to continue to follow the PACT II sample, one final time, every 6 months for 36 months, as the middle adolescents transition to late adolescence/young adulthood. Specific aims are to: 1. evaluate longitudinally youth adjustment (i.e., mental health, behavioral adjustment, social outcomes--and including new measures for late adolescence/young adulthood of career goals, pregnancy planning and expectancies, and further mental health measures); 2. evaluate youth characteristics from across developmental periods that may moderate or mediate the impact of MLHs' chronic illness on patterns of youth adjustment over time, including: (a) background factors of age, gender, ethnicity; (b) moderating and mediating factors, such as self-concept, family cohesion and the parent- child relationship, HIV/AIDS knowledge and perceived stigma, gender role, autonomy, and development of romantic relationships and including new measures of parent-adolescent separation, and communication; interpersonal support; identify formation status, adolescent/mother communication regarding sexual issues; 3. evaluate maternal characteristics that may moderate or mediate the impact of MLHs' chronic illness on the youth (e.g., illness severity, mental health status, social support, parenting skills, empty nest issues); and 4. conduct in-depth qualitative interviews once per year for three years, twice with the adolescents and once with MLHs, with research questions derived from PACT II data and from data collected in this study. To our knowledge, this would be the first cohort of children in the U.S. affected by maternal HIV/AIDS followed all the way from early school age through late adolescence/early adulthood. Our findings indicate that growing up with a mother with HIV/AIDS may lead to different outcomes than becoming aware as an older adolescent, and the longer term ramifications of living since childhood with a mother who has a chronic, highly stigmatized illness has not been investigated prospectively. PUBLIC HEALTH RELEVANCE This is a competing renewal to extend and expand a longitudinal study that has been conducted over the last 10 years, assessing mothers living with HIV and their well children. The children are now transitioning to late adolescence/young adulthood, and this research would continue to provide information on interventions needed for children affected by maternal HIV, as well as information on the needs of HIV-positive mothers. This would be the first cohort of children affected by maternal HIV/AIDS followed all the way from early school age through late adolescence/early adulthood, allowing investigation of long-term outcomes of these children.